Erectile Dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse ED affects many men and is often caused by psychological, biological or a combination of both. This section takes a closer look at the main causes of ED.
Biological Causes
Vascular Disorder
The most common biological cause of erectile dysfunction (ED) is vascular issues. An erection occurs when sexual stimulation causes a large amount of blood to flow into the penis, but if the blood vessels do not function properly, this process is disrupted, leading to an inability to achieve a sufficient erection. Vascular problems are associated with conditions such as atherosclerosis, hypertension, and diabetes, all of which affect the cardiovascular system.
Arteriosclerosis
Atherosclerosis refers to the buildup of plaque on the inner walls of arteries, causing the blood vessels to narrow. As a result, blood flow is restricted, preventing the necessary amount of blood from reaching the penis. Since the arteries in the penis are narrow and delicate, atherosclerosis often affects them early, sometimes appearing as a warning sign of other cardiovascular diseases like heart disease or stroke. For this reason, ED is often considered a key indicator of vascular health, with atherosclerosis being a common underlying cause.
Hypertension
Hypertension (High Blood Pressure) is another common cause of ED. High blood pressure increases the pressure on blood vessels over time, causing them to stiffen and their inner walls to become damaged. This reduces blood flow to the penis and makes it difficult to achieve an adequate erection. Some hypertension medications can also cause ED.
Diabetes Mellitus
Diabetes is another significant cause of ED. When blood sugar levels are poorly managed in diabetes, it often leads to damage to blood vessels and nerves, increasing the risk of ED. Diabetic neuropathy, in particular, can damage the nerves in the penis, preventing a normal erectile response. Additionally, diabetes increases the risk of atherosclerosis, compounding blood flow issues and potentially worsening ED.
Other Vascular Problems
Additionally, heart disease and high cholesterol can also cause ED. Heart disease weakens the heart’s ability to pump blood throughout the body, which may result in insufficient blood flow to the penis. High cholesterol increases the risk of atherosclerosis, causing arteries to become clogged or narrowed, further restricting blood flow.
Neurological Disorder
Stroke or Trauma
Strokes and head and spinal cord trauma that damage the brain or spinal cord can interfere with the transmission of nerve signals and adversely affect erectile function. When nerves in the brain or spinal cord are damaged, signals to the penis cannot reach the penis, making erection difficult.
Diabetes Mellitus
Diabetes is one of the leading causes of neuropathy (diabetic neuropathy). When peripheral nerves are damaged by diabetes, they are less able to transmit signals to the penis, increasing the risk of ED. Diabetics are more susceptible to nerve damage due to high blood sugar, which can affect erectile function.
Nerve damage after prostate surgery
Surgery in the pelvic region, such as prostate or bladder surgery, can damage nerves leading to the penis. In particular, prostatectomy, performed as a treatment for prostate cancer, can damage nerves important for erection, and ED may occur after surgery. If the nerve damage caused by surgery does not heal, long-term ED may persist.
Multiple sclerosis and Parkinson’s disease
Neurodegenerative diseases such as multiple sclerosis (MS) and Parkinson’s disease affect nerves in the brain and spinal cord, impairing various body functions, including erectile function. In these diseases, nerve signals from the brain are no longer transmitted properly, making ED more likely to occur.
Spinal Cord Injury
Spinal cord injuries can also seriously affect erectile function. When the spinal cord is damaged, nerve signals to the penis are blocked and erection may be completely lost or very difficult. Depending on the level and extent of spinal cord injury, the degree of ED can vary, but in severe cases sexual function can be severely impaired.
Hormonal Abnormality
Low testosterone levels can cause ED. Testosterone is a major regulator of male libido and a drop in this hormone can lead to decreased libido and reduced erectile capacity. Other hormonal abnormalities, such as thyroid dysfunction and adrenal disorders, are also associated with ED.
Chronic Malady
Chronic diseases such as heart disease, high blood pressure, high cholesterol, diabetes and obesity increase the risk of ED. These diseases often directly affect vascular and nerve health, which in turn negatively affects erectile function.
Psychological Causes
Stress and Anxiety
Stress in daily life and anxiety about performance in certain situations can cause ED. Stress and anxiety activate the sympathetic nervous system and inhibit the body’s ability to relax, which is necessary to achieve an erection.
Depression
Depression and other mental health problems are also common psychological causes of ED. Depression can also affect sexual function as it reduces self-esteem and decreases sexual desire. Some drugs to treat depression may also have side effects on sexual function.
Relationship Problems with Partners
Relationship problems with the partner, such as lack of emotional closeness or communication problems, can also cause ED.
Hiro Clinic offers internal treatment for ED. Please feel free to consult with us. We also have a psychosomatic medicine department on site, so we can also deal with possible psychological causes.
